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donderdag 17 augustus 2017

The Lancet: [Articles] Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, ...

[Articles] Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial
Tenecteplase was not superior to alteplase and showed a similar safety profile. Most patients enrolled in this study had mild stroke. Further trials are needed to establish the safety and efficacy in patients with severe stroke and whether tenecteplase is non-inferior to alteplase.
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[Comment] NOR-TEST-ing tenecteplase in acute ischaemic stroke
Despite the transformational impact of endovascular treatment on patients with acute ischaemic stroke from proximal cerebral artery occlusion, thrombolysis with intravenous alteplase remains the mainstay of reperfusion therapy because it is widely available and the standard of care upon which the evidence for endovascular treatment has been based.1 However, because alteplase has well recognised limitations, including reduced efficacy in large clots, risk of major intracranial haemorrhage, and requirement for a continuous infusion, there is an imperative to continue efforts to find more efficient, more effective, and safer lytic treatment in acute ischaemic stroke.
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[Comment] T cells and Parkinson's disease
Although effector and regulatory T-cell populations can promote either neurotoxic or neuroprotective effects in the control of the brain's microenvironment, how these cells are induced during Parkinson's disease is not known.1,2 David Sulzer and colleagues3 have reported a functional role of α-synuclein in immune tolerance. The authors posit that lymphocyte populations emerge from α-synuclein induction of autoreactive CD4+ and CD8+ T cells.
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[In Context] Communication at the borders of consciousness
Consciousness and concepts of the mind have long been central to medical, scientific, and philosophical debate. Yet it is only with recent advances in technology that we have been able even to capture functional processes in the brain, let alone make the leap from observing certain neural activity patterns to trying to define consciousness. A significant contributor to field is the lab led by Adrian Owen, who in his decades-long research into brain injury has pioneered breakthrough techniques in imaging and communicating with patients in persistent vegetative states.
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[In Context] Flashing lights and poor funding: more than a headache
For many migraineurs, daily life can be a carefully choreographed routine of avoiding triggers. So to intentionally induce a migraine seems not only ill-advised, but also foolish. Yet, that is precisely what author A L Kennedy did for the BBC Radio 4 production AL Kennedy's Migraine. At the start of the programme, Kennedy thoughtfully advises listeners for whom simply hearing about symptoms of migraines might trigger an attack, "Please, don't soldier on, the way we sometimes do, switch this off.
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